It’s far from a new business, but the fact that Orthopedic Institute will hold a Sioux Falls Area Chamber of Commerce ribbon cutting later this month is one sign of how things are changing inside the independent orthopedics organization.

The event will symbolize OI’s recent partnership with Core Orthopedics & Sports Medicine, which integrated their operations in April and created a combined practice of 17 orthopedic physicians, two additional physicians and 20 physician assistants and nurse administrators.

“We got everybody physically under one roof April 1 and got them working together as a solid, functioning team to take care of folks, so we’re pretty happy with it,” said Dr. Blake Curd, OI’s president.

The new addition is among many changes for the organization, which is based at 810 E. 23rdSt. on the Avera McKennan campus. Avera purchased the 87,000-square-foot building this year from its original developer.

OI leases floors three through five and part of the first floor, and Avera uses the rest of the building.

“For us, it was a non-event,” Curd said. “We’re not planning on going anywhere. We’ve been a big part of this campus and … we’re happy with the location. It’s close to what we do, and patients know where we are. We’ll see what the future brings. Right now, we’re pretty satisfied.”

OI recently finished some construction projects, including a renovated area for staff to take breaks, and it’s bringing in a new MRI unit this summer to drive efficiency and replace 20-year-old equipment.

“We’re utilizing about every square foot we can,” Curd said. “We don’t have much room for many more surgeons or PAs or nurse practitioners.”

The organization also is going through a leadership change at the top.

Former CEO Cindy Jacobs left in March and is “pursuing other things,” Curd said, and interim CEO Lynda Barrie was brought in as a specialist for refining business operations.

“We’re making sure we’re operating at peak efficiency, so we can continue to drive cost out. We want to make sure we’re the best value for orthopedic surgery in the market,” he said, adding OI plans to fill the CEO position.

“We’re recruiting for talented individuals now.”

The business model also has absorbed decisions in recent years by Sanford Health and Avera not to cover care at OI for their employees through their respective health plans. Sanford made the decision a couple of years ago. Avera did recently, and it will take effect Nov. 1.

Both major health systems have been building their own orthopedics teams.

“Avera has built a world-class orthopedics team,” chief human resources officer Kim Jensen said in a statement.

“With over 40 providers, Avera Orthopedics is the largest orthopedic physician team in the region. That’s why Avera leaders have made the decision that Orthopedics Institute, Core Orthopedics and care at Sioux Falls Specialty Hospital will no longer be covered for members of our employee health plan.”

“I can’t understand a health care business fundamentally not letting their people be taken care of where they want to be taken care of. The best place possible may not be your own shop, and you want them taken care of where they feel most comfortable.”

He said he didn’t know how many current OI patients are Avera employees, adding that Sanford’s decision not to cover its employees’ care at OI didn’t seem to have a quantifiable impact.

“OI has been growing so much I can’t tell you noticed anything at all,” he said. “We continue to do better and better every year, so I haven’t seen a noticeable impact, other than the anecdotal stories from Sanford employees and physicians.”

OI’s growth strategy includes what Curd calls a “robust outreach program” to communities outside Sioux Falls and an eye toward serving communities closer to the city limits with clinics.

“Those are areas where we might put more time and energy into seeing what our patients would like us to do and where they would like us to be.”

The organization also has rebranded its training center at 69th Street and Southeastern Avenue as OI Performance, dropping an affiliation with D-1, a national athletic training business.

“We found we were doing 100 percent of the work in the local market without a lot of increased value from our corporate partner, so although we were happy with the initial association, it didn’t make sense to continue,” Curd said. “They were headed in a little different direction, and we get rave reviews from the training experience people get here. Some of our elite athletes really take advantage of it.”

Despite increased competition in the orthopedics field, demand remains strong, Curd added. “We’ve been around a long time, and a lot of our physicians have well-established practices,” he said.

“And I think it’s tougher for someone brand new to come in and put a flagpole and say this is where you should be taken care of. One of the advantages of OI is almost all our physicians have some kind of roots in South Dakota.”

Being located in a fast-growing community helps, he added.

“There continues to be opportunity here. We’ll have to see what the future brings, but we’re pretty satisfied with what we’re doing and where we are.”